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The problem with “natural” childbirth

I had a colleague ask me a while back if I had delivered my son naturally. I responded, “What do you mean by ‘naturally’?” You see, I’ve heard this term thrown around to mean lots of different things to different people. To some it means a vaginal delivery where no pain medication was used. For others, a vaginal delivery where IV pain medication was given (but not an epidural) still counts. And for still others, naturally means at home in a tub, with no doctors around.

Her answer? Well, I can’t remember. But that’s not the point.

I know that whenever a pregnant patient uses that term and I clarify what she means (which for many is a vaginal delivery, sans any pain medications), I tend to replace it with the term “unmedicated.” This may seem like a small, annoying splitting-of-hairs difference to you, but I’ll explain why I prefer it—and why I think it more accurately reflects what we mean.

You see, many women who plan on a low-intervention, epidural-free birth achieve just that. However, for those who end up with an epidural, or the need for Pitocin, or have to deliver via Cesarean section—many of them mourn the loss of what they imagined. I have seen couples erupt into huge arguments when a woman wants to have some IV pain medication, only to have her husband tell her it wasn’t the way they planned her labor and that she could be “stronger than that.” That those medications weren’t “natural.”

You may think it’s no big deal if, in the end, they have a healthy baby (and we have a healthy mom) and they should just get over how their little one arrived, but that’s a lot easier said than done. It also marginalizes how a woman feels about a very important day in her life, one that she had looked forward to for a long time.

And then someone asks her if she had a “natural” delivery, and she reads into it: You think I am unnatural because I got that epidural. You think I gave in and had a C-section too easily. You think I was probably duped into my C-section.

I’ve seen lots and lots of women who have echoed those exact words at their postpartum visits. They know that most people don’t ever intend to insinuate anything negative by using the term “natural,” but they readily admit to disliking that reference when an unmedicated delivery didn’t happen for them.

In this era of parenting trends, labels can really affect our personal view as a mother. Are you enough of an attachment parent? Are you enough of a free-range parent?  Are you natural enough? The persona starts even before the baby arrives, with whether or not his or her mother had an epidural.

So in the end, I’ll tell a mom, “Let’s call it an unmedicated delivery, and if you end up birthing something the size of a watermelon out of your vagina—epidural or not—you’re still pretty natural to me.”

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About Dr. Jennifer Lincoln, Bundoo OB/GYN

Dr. Jennifer Lincoln is a generalist obstetrician/gynecologist and attending physician at a tertiary-care hospital in northeastern Pennsylvania. She spends the majority of her time on labor and delivery, but manages to fit in some outpatient clinic and operating time.

Comments

  1. I had my children with a midwife and no medication, and I don’t know if I’ve used the term “natural childbirth,” because I agree it’s not particularly meaningful. But I will say that it can be kind of touchy when I try to talk to a medical provider and I get corrected by her when it’s already hard enough to express myself. It’s potentially condescending.

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    1. True, it certainly depends on the tone and context!

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  2. “Natural” isn’t always best. I am on baby #4 and for the first time will be having a scheduled c-section (hopefully). When I asked the perinatal specialist about it at the beginning of my pregnancy I was told that in this case it was my decision. He then Told me with a big smile that every OB in the hospital would stand by me as no one wants to be in the On Call room when a 40 year old diabetic with a previous shoulder dystocia comes through demanding to deliver vaginally. Like all moms, I just want the safest delivery for my baby.

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    1. Yes – as long as you and your doc have come to a plan that works best for you, that is all that matters!

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    1. Jennifer, what a beautiful sentiment.

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    2. I LOVE this times a million.

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    1. Very true! Though it’s important to realize the mom may not have had the birth the way she had hoped for, which even though it may seem trivial it still may make her adjusting to life with a little one a little harder, especially if she’s being made to feel guilty for having an epidural or a C-section etc. I totally agree you are a mom either way, so let’s not make women feel badly for how they birthed!

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  3. I honestly think that how one delivers their baby is about as much the rest of the world’s business as the details of the conception. I get asked on a regular basis if my twins were conceived naturally, if they run in my family and all of that. It is AS irritating as people asking if I had a c section or an epidural or whatever. It’s not their business. I understand when friends ask, but when total strangers ask all of these fairly personal questions, or even coworkers and acquaintances, it feels fairly invasive. We live in a TMI world and I feel like we should revert back to a world where privacy and modesty matter

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    1. Yes! Couldn’t agree more. Unless someone offers I tend to not ask those questions because they truly are personal, and you never know the backstory…

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  4. I guess according to most women I’m a quitter. I really did not want to give birth ‘naturally’ or ‘unmedicated’ (or whatever term you want to use). I asked for an epidural because I knew this was going to HURT. My water broke at home and I was not dilating fast enough to save getting an infection so they induced me-pitocin drip and pill. That in itself was hell, then I get jostled awake and told to start pushing, my baby was stuck as my hips didn’t separate enough and I had to have an emergency C section. Now the reason I am telling all of this is because my head was filled with all that crap from other mothers AND the nurses that you should shoulder through the agony, push your baby out ‘naturally’ because that was what being a woman was all about. After I was told I had to have a C section, I bawled and apologized to my then husband that I failed as a woman since I couldn’t even push my baby out. I have come to realize that is utter nonsense. A woman should have the right to have her child HOWEVER she wants to and not be condemned OR praised because she chose a certain method. C’mon people! We are bombarded with enough garbage being female, we don’t need this added to it. You had a healthy child-be amazed at giving life to another human being!

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    1. Agree! Birthing a child is different for everyone, and as long as everyone ends up OK in the end is all that matters. A cesarean birth is still giving birth, and making women feel like they are “less” of a mom because they delivered that way is so sad.

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    1. I agree 100%!!

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    1. Yadira I completely agree with you! Many people feel that all the details are ok to ask and like you, I think privacy needs to be respected.

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  5. That last part So in the end, I’ll tell a mom, “Let’s call it an unmedicated delivery, and if you end up birthing something the size of a watermelon out of your vagina—epidural or not—you’re still pretty natural to me.”
    Is kind of a middle finger to induced/c-section mothers.

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    1. Sarah, that last sentence was my attempt at humor (which is why I keep my day job!). I promise I was not including a virtual middle finger in my article!

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  6. I think it’s great to promote childbirth the way nature intended it, but I think the focus is on the wrong topic of childbirth. Pain management DURING labor and deliver is everyone’s major focus. Those are personal choices that don’t make childbirth any less natural by no means. I wish the focal point would be shifted to reflect the importance of “spontaneous” labor versus “induced” labor. If medically necessary, I have no argument against “induced” labor. Otherwise, waiting for nature to tell you when the time is right is a much more important point as to whether it was natural. I think there is a gross over-use of scheduled deliveries by doctors. Without a doubt, labor inducing drugs (pitocin) may mimic your body’s natural hormones, but CANNOT DUPLICATE the exact science nature produces with your natural chemistry. With that said, consider that letting NATURE do it’s job might possibly reduce complications as it’s the only exact science (which can’t be measured) and save the MEDICINE for when the need arises. And for everyone preaching the natural kick… If you deliver in a hospital, you’ll be given pitocin anyways post-birth to induce contractions afterwards. All-in-all, EVERY CHILDBIRTH IS NATURAL. Nature allowed conception to be possible (regardless of method), growth of a little human inside of you (natural again!), and the delivery of that little creature (regardless of method).

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    1. Krystal, you are right that inductions are over utilized! We cover that here: http://bit.ly/1BgmJuq

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  7. I never say the word “natural” for some of the reasons listed above. I think of a natural birth as unmedicated but others may think differently so when somebody asks I say that I had a vaginal birth with an epidural.

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  8. I laughed out loud at the ending! The point about the connotation of the word “natural” is interesting and I’ve never thought about it that way. One thing is for sure, though: a woman’s decision about childbirth is one that should be supported and not judged. As someone who chose an “unmedicated” delivery and was lucky to be able to conceive as planned, I’ve received the opposite discrimination in the way of friends afraid to tell me about their choice to get an epidural or friends questioning my choice not to cloth diaper (apparently the two choices are related?). I support every woman decision to do what’s best for her… Honestly, isn’t it amazing that we have these options?

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